Suboxone Treatment Programs – Understanding the Drug and its Uses – Part 1

What is Suboxone?

Suboxone is the brand name of a medication for the treatment of Opioid Use Disorder. Most people associate the treatment by the brand name of medication, but what people are thinking of is the active ingredient Buprenorphine. The active ingredient Buprenorphine comes in many medications, delivery methods, and is best paired with Naloxone. Suboxone is a medication which has Buprenorphine and includes the active ingredient of Naloxone which assists in preventing any current usage and accidental overdoses on opioids and opiates. In the United States, Buprenorphine (Suboxone) was first approved by the Food and Drug Administration (FDA) for use of treatment of Opioid Use Disorder on October 8, 2002.

Buprenorphine works as an opioid partial agonist. This is different than that of Methadone, another commonly used medication for the treatment of Opioid Use Disorder. Methadone is a full opioid agonist. There are many differences between a partial and a full opioid agonist. Partial opioid agonists bind to the cells’ opioid receptor sites, but do not produce the full effect that the full agonist opioids will produce. So, what does this mean? This means that Buprenorphine will assist in reducing cravings and effects of withdrawal associated with opioids. It also means that there is a “ceiling effect” with a partial agonist and that after a certain dosage of the medication, there are no additional effects. This is extremely helpful in addiction treatment and provides a safeguard against the medication being abused. Also, with a partial opioid agonist there is less physical dependency on medication such as that with Methadone. To give an example, Methadone as mentioned is a full opioid agonist, which other full opioid agonists are Fentanyl, Heroin, and Morphine. Buprenorphine has a greatly decreased chance of misuse over that of full opioid agonists.

Suboxone is a combination of Buprenorphine and Naloxone, which is the preferred medication for the treatment of Opioid Use Disorder as it is a partial opioid agonist and an antagonist. The Naloxone is the opioid antagonist part of the medication. This means that the Naloxone attaches to the opioid receptor sites but will either reverse or block the effects of other opioids and opiates. This is why Suboxone (Buprenorphine and Naloxone combination) is preferred for treatment, in that the Buprenorphine first will work to assist with cravings and withdrawal, while the Naloxone will prevent the misuse of other opioids and opiates. This medication is great to assist in prevention of overdoses while a person is working on their substance abuse recovery. Naloxone has assisted in the prevention of both fatal and nonfatal overdoses with great success.

The main use of Suboxone is for the treatment of Opioid Use Disorder. It is used to assist someone that is physically and/or psychologically addicted to opioids and/or opiates to get off of those drugs without issues with cravings and withdrawal. Buprenorphine was originally created in the 1970s as a safer alternative to pain medication. Buprenorphine has since been used as a type of pain medication and it was in 2002 when it was deemed as a safter and effective treatment for Opioid Use Disorder by the FDA. Buprenorphine is best used when combined with the medication Naloxone such as in the brand medication named Suboxone.

Suboxone has a role in the treatment of Opioid Use Disorder with Medication Assisted Treatment (MAT), which is now called Medications for Opioid Use Disorder (MOUD) treatment. Suboxone is used to assist the individual with alleviating the effects of both withdrawal and cravings. It is highly recommended that the person in this type of treatment also seek addiction counseling to pair with the medication as this will have the highest chance of success. As Buprenorphine can assist with the physical components of substance abuse recovery, there are many other psychological factors that need to be addressed at the same time to increase the chance of successful and sustained recovery.

Benefits and Effectiveness of Suboxone

There are many benefits to Suboxone or Buprenorphine treatment. One of the first benefits is that Suboxone or Buprenorphine is less habit forming than that of the other medication Methadone due to Buprenorphine being a partial opioid agonist. The main use of Suboxone or Buprenorphine is also the main benefit of this medication. This benefit is that it will alleviate your withdrawal symptoms and assist in decreasing or eliminating the physical cravings for opioids and opiates. With Suboxone which is the combination of Buprenorphine and Naloxone, the Naloxone assist as an assisted safeguard for relapse and overdoses.

As Suboxone does act as an antagonist of the kappa and delta opioid receptor sites, research has shown that Buprenorphine can have antidepressant effects. This means that during the treatment the use of this medication can help with some symptoms of depression, even though this is not the intended use of the medication. If you are suffering from depression, which is common to happen with substance use disorders, it is highly recommended that you seek psychiatric assistance and medications specific to depression.

The role of Suboxone in the treatment of Opioid Use Disorder is to treat the physical symptoms of withdrawal and cravings. As mentioned earlier, this is just one aspect of treatment and the combination with psychological services such as counselling is also recommended. Suboxone will allow you to safely avoid the discomforts of withdrawal while you work on your recovery. Also, while on Suboxone you can taper down off the medication in a controlled and medically monitored method, unlike that of other opioid and opiates purchased on the streets. Avoiding cravings while on Suboxone will assist in recovery as well, however psychological triggers may persist, which counseling can greatly assist with.

The National Institute on Drug Abuse reported in 2021 that research has proven that the usage of Buprenorphine or Suboxone for the treatment of Opioid Use Disorder is effective. In the research that has been reviewed shows that patients which use Buprenorphine or Suboxone are 1.82 times more likely to stay in treatment than those attempting treatment without the assistance of any medication. During the studies reviewed it was noticed that there was a statistically significant increase in the opioid negative drug tests by those in the studies who were taking Buprenorphine/Suboxone, showing adherence to recovery and sobriety with the assistance of Buprenorphine/Suboxone.

In a Swedish study of patients in Suboxone or Buprenorphine treatment, when comparing those on the medication versus those on the placebo (a placebo is a false medication with no active properties, but the patient is not aware of the medication being fake), those on the placebo had 100 percent failure in treatment where those on the Buprenorphine had a success rate of 75 percent. This shows great success with Buprenorphine or Suboxone, even over that of Methadone which typically yields a success rate around 67 percent, in the respective studies mentioned in the article by The National Institute on Drug Abuse. It is important to note here that there is greatly more research on Methadone than Buprenorphine or Suboxone as Methadone has been used in treatment since 1947 compared to 2002 for Buprenorphine based medications such as Suboxone, Sublocade, Subutex, Zubsolv, and Bunavail.

Another medication that is used to treat Opioid Use Disorder is Naltrexone. As this is also a great medication and has helped many individuals in treatment, there is one main difference between it and Buprenorphine or Suboxone. This main difference is that Naltrexone requires the patient to be in full detoxification which limited the chances many individuals would make it to this point to start the treatment. As of 2021 there was not sufficient evidence to support the effectiveness of the oral version of Naltrexone but was sufficient evidence to support the injectable version. Comparing Buprenorphine/Suboxone and Naltrexone effectiveness on continued treatment recovery, data shows similar success rates, supporting both as a means of treatment for Opioid Use Disorder.

One of the biggest benefits of Suboxone is the addition of Naloxone with Buprenorphine. In a research article by Harvard Health in 2021 they reported that the use of Suboxone (which will always include Naloxone) has shown to lower the risk of fatal overdoses by 50 percent. The addition of the Naloxone also greatly reduces the risk of nonfatal overdoses, which are still medically dangerous and physically traumatic. Therefore, the use of Buprenorphine with Naloxone (Suboxone) is the preferred method of treatment in the realm of Buprenorphine based Medications for Opioid Use Disorder (MOUD) treatments./p>

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